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Utilization Review Jobs in Moncks Corner, SC (NOW HIRING)

NHC HomeCare - Aiken

Physical Therapist - PRN

Holly Hill, SC · On-site

$1.6K - $2.1K/wk

Serves as Utilization Review and/or Advisory Board Member as requested by Administrator/Director * Contributes to physical therapy related CQI, as requested * Participates in interdisciplinary ...

NHC HomeCare - Aiken

Physical Therapist - PRN

Holly Hill, SC · On-site

$1.6K - $2.1K/wk

Serves as Utilization Review and/or Advisory Board Member as requested by Administrator/Director. * Contributes to physical therapy related CQI, as requested * Participates in interdisciplinary ...

Tristar Insurance

Supervisor, Case Management

SC · On-site +1

$110K - $118K/yr

This position involves close collaboration with the Nurse Triage, Utilization Review, Case Management and Pharmacy teams. The Supervisor must have up-to-date knowledge of evidence-based nursing ...

Harris Teeter

Part Time Pharmacy Intern P4

Summerville, SC · On-site

$15 - $18.50/hr

Notify the pharmacist in the event of earlyfills or drug utilization review (DUR) messages. Ensure DAW codes are entered correctly. 7. Assist in obtaining and returning medications to and fromthe ...

Encompass Health

Controller

North Charleston, SC

Relevant experience in financial management and financial operations, including but not limited to labor management, revenue analysis, expense management, contract negotiation, and utilization review.

Harris Teeter

Part Time Pharmacy Intern P1-368

Summerville, SC · On-site

$15 - $18.50/hr

Notify the pharmacist in the event of earlyfills or drug utilization review (DUR) messages. Ensure DAW codes are entered correctly. 7. Assist in obtaining and returning medications to and fromthe ...

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All JobsUtilization Review JobsUtilization Review Jobs in Moncks Corner, SC

Utilization Review information

See Moncks Corner, SC salary details

$18

$37

$60

How much do utilization review jobs pay per hour?

As of Jul 29, 2026, the average hourly pay for utilization review in Moncks Corner, SC is $37.13, according to ZipRecruiter salary data. Most workers in this role earn between $29.33 and $42.64 per hour, depending on experience, location, and employer.

What jobs make $3,000 a day?

High-paying jobs that can reach $3,000 a day include specialized roles such as senior physicians, anesthesiologists, or surgeons, often requiring advanced certifications and extensive experience. Certain executive positions, like CEOs or investment bankers, may also earn this level of daily income, especially through bonuses or profit sharing. These roles typically involve high responsibility, expertise, and demanding schedules.

What jobs pay 4000 a week without a degree?

Utilization Review specialists typically do not earn $4,000 per week without a degree; most roles in this field require healthcare-related certifications or experience. High-paying jobs that can reach this level without a degree include certain sales positions, real estate brokers, or specialized trades like commercial pilots or skilled trades, which often rely on experience, licensing, or certifications rather than formal degrees. These roles may involve commission, bonuses, or overtime to achieve such weekly earnings.

What does a typical day look like for someone working in Utilization Review?

A typical day in Utilization Review involves reviewing patient medical records, evaluating the necessity and appropriateness of proposed treatments or services, and documenting recommendations based on clinical criteria and insurance policies. Utilization Review specialists often collaborate closely with physicians, nurses, and insurance representatives to gather additional information and clarify cases. While much of the role is desk-based and may include remote work options, it requires regular communication with both clinical and administrative teams. This position offers variety and challenge, as no two cases are exactly alike, and there are often opportunities to advance into supervisory or quality improvement roles within the department.

What skills do you need for utilization review?

Utilization review professionals need strong analytical skills to assess medical necessity and appropriateness of care, attention to detail, and knowledge of healthcare regulations and insurance policies. Good communication skills are essential for coordinating with healthcare providers and explaining decisions. Familiarity with electronic health records (EHR) systems and relevant certifications, such as Certified Professional in Healthcare Quality (CPHQ), can also be beneficial.

What is a Utilization Review job?

A Utilization Review (UR) job involves assessing the medical necessity, efficiency, and appropriateness of healthcare services. UR professionals, often nurses or healthcare specialists, review patient records, insurance claims, and treatment plans to ensure they meet industry standards and payer requirements. They work with healthcare providers, insurance companies, and regulatory agencies to optimize care while controlling costs. Their goal is to balance quality patient care with cost-effective resource utilization.

What are the key skills and qualifications needed to thrive in the Utilization Review position, and why are they important?

To thrive in Utilization Review, professionals typically need a background in nursing or healthcare, strong clinical assessment capabilities, and a thorough understanding of medical guidelines and insurance regulations. Familiarity with electronic medical records (EMR) systems and utilization management software, and often certification such as Certified Utilization Review Specialist (CURN), are important. Excellent critical thinking, attention to detail, and strong communication skills enable effective case evaluation and collaboration with healthcare teams. These skills and qualifications ensure objective, accurate decisions that support cost-effective, quality patient care within compliance standards.

How do I get into a utilization review?

To become a utilization review specialist, typically a healthcare professional such as a registered nurse, licensed social worker, or physician completes relevant education and gains experience in healthcare or insurance. Certification in utilization review or case management, such as the Certified Professional in Healthcare Quality (CPHQ), can improve job prospects. Strong analytical skills and knowledge of medical coding and insurance policies are also important.
What are the most commonly searched types of Utilization Review jobs in Moncks Corner, SC? The most popular types of Utilization Review jobs in Moncks Corner, SC are:
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What cities near Moncks Corner, SC are hiring for Utilization Review jobs? Cities near Moncks Corner, SC with the most Utilization Review job openings:
Utilization Review jobs near you
Infographic showing various Utilization Review job openings in Moncks Corner, SC as of July 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, 1% Temporary, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $77,222 per year, or $37.1 per hour.

Utilization Review Nurse

Integrated Resources INC

North Charleston, SC

Other

Re-posted yesterday

Job description

Company Description

Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow.

We've stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity.

Our team works hard to deliver a tailored approach for each and every client, critical in matching the right employers with the right candidates. We forge partnerships that are meant for the long term and align skills and cultures. At IRI, we know that our success is directly tied to our clients' success.

Job Description

Responsible for conducting timely reviews of all requests for services required to meet medical necessity criteria to include reviewing pre-certification for outpatient and inpatient services

Applying criteria to inpatient admissions and performing concurrent review functions, identifying discharge planning needs and referral of members to case management.

Evaluates clinical information submitted by providers against plan review criteria and benefit guidelines

Utilizes clinical information to determine if criteria for medical necessity and benefit guidelines are met

Utilizes professional judgment to determine if additional information is required, then follows through to obtain additional information prior to making a decision

Documents all pertinent case information and dispositions for approvals and denials

Refers all cases failing to meet interqual medical necessity criteria to Medical Director for review and final determination

Communicates with providers to initiate/coordinate outpatient services/discharge planning needs for members

Acts as a liaison to assure services are provided in the least restrictive, most cost effective and clinically appropriate setting

Works with the Utilization Management Manager, the Medical Director and providers to ensure that complete medical information is available to allow utilization management decisions to be made within The Plan's standards for decision making

Identifies potential members who may benefit from case management services and facilitates referral to the program

Identifies and resolves any problems that could interfere with provider's continuity and coordination of care of members and refers unresolved problems to Manager

Creates and maintains monthly reports on inpatient activities

Performs other related duties and projects as assigned

Adheres to ACFC policies and procedures

Supports and carries out our Mission & Values.

Qualifications

Associates RN degree required, Bachelor's degree preferred

Two years of experience in managed care quality assurance or utilization review

RN must have two years of experience in an acute care hospital.

Additional Information

Thanks

Warm Regards

Ricky Bansal

732-429-1925

Integrated Resources logo

About Integrated Resources

Sourced by ZipRecruiter

Integrated Resources Inc (IRI), based in Edison, NJ, US, is an esteemed player in the staffing solutions industry with a credible presence on their official website irionline.com. Notably, IRI provides a range of professional staffing services including contract, contract-to-hire, and direct hire solutions to a wide spectrum of industries such as healthcare, life sciences, manufacturing, financial, insurance, and others. Since its inception, IRI has been committed to delivering top-talent and optimum solutions to meet its clients' diverse needs.

Industry

Recruiting and staffing services

Company size

51 - 200 Employees

Headquarters location

Edison, NJ, US

Year founded

1996

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